Randomized clinical study comparing Compeed® cold sore patch to acyclovir cream 5% in the treatment of herpes simplex labialis

Background Hydrocolloid technology has been proven effective in treating dermal wounds. A previous study showed that a newly developed thin hydrocolloid patch [Compeed® cold sore patch (CSP)] provided multiple wound‐healing benefits across all stages of a herpes simplex labialis (HSL) outbreak. Methods An assessment of CSP efficacy and safety was conducted in an international, multicentre, assessor‐blinded study, which enrolled 728 subjects with a history of recurrent HSL. Of these, 351 experienced an HSL outbreak and were randomized to use CSP (n = 179) or acyclovir cream 5% (n = 172) at the onset of symptoms until the lesion healed, for a maximum of 10 days. The primary end point was the subject's global assessment of therapy (SGAT; 0–10 scale; 0 = no response, 10 = excellent response). Multiple secondary end points included clinician‐assessed healing time and subject assessment of lesion protection, noticeability and social embarrassment. Results CSP and acyclovir were highly effective (mean SGAT = 7.89 and 8.00, respectively), with no significant difference observed (P = 0.65). The difference in healing times between products was not significant (median, 7.57 days with CSP vs. 7.03 days with acyclovir, P = 0.37). Both treatments were well tolerated. Conclusion CSP using hydrocolloid technology provides an efficacious and safe alternative to topical antivirals in treating HSL as a wound while affording additional immediate benefits of wound protection, discretion and relief of social embarrassment.     

Variables affecting weight gain in renal transplant recipients

Previous studies of renal transplant recipients have suggested that weight gain after transplantation is relatively common, especially among certain populations. We conducted a retrospective review of 977 renal transplant recipients at the University of Alabama at Birmingham to identify patterns of weight change (as mean percentage of body weight at transplantation) attributed to race, sex, income, age at transplantation, pretransplantation time on dialysis, incidence of diabetes, rejection episode(s), and/or obesity (body mass index >/= 30 kg/m(2)) at transplantation. Patients were evaluated at 3, 6, 9, and 12 months posttransplantation and at 2 and 3 years, when available. Univariate analysis at 1 year showed that blacks achieved a greater weight change than whites (P = 0.0004), women had greater gains than men (P = 0.0001), and low-income patients had greater mean gains versus medium- (P = 0.0001) and high-income patients (P = 0.0001). Advancing age and weight gain were inversely correlated (P = 0.0002). Having one or more rejection episode indicated less weight gain than having no rejection episode (P = 0.0220). Incidence of diabetes or time on dialysis was not a significant predictor of weight gain. Black race, female sex, low income, younger age, and no incidence of rejection episodes were significantly associated with weight gain at 1 year in the multivariate analysis.     

用气囊充气模拟结肠镜引起大鼠胃运动的变化

1 对象和方法成年雄性SD大鼠84只,清洁级,体质量(200±20) g. 置于安静、温暖(20℃)、避强光的环境中饲养. 随机均分成2组,每组42只; 再随机均分成7个亚组用于直肠顺应性检测,制定压力曲线.     

Cultural tailoring for the promotion of Hepatitis B screening in Turkish Dutch: a protocol for a randomized controlled trial

Background  

Chronic hepatitis B virus infection (HBV) is an important health problem in the Turkish community in the Netherlands, and promotion of screening for HBV in this risk group is necessary. An individually tailored intervention and a culturally tailored intervention have been developed to promote screening in first generation 16-40 year old Turkish immigrants. This paper describes the design of the randomized controlled trial, which will be used to evaluate the effectiveness of the two tailored internet interventions as compared to generic online information on HBV, and to assess the added value of tailoring on socio-cultural factors.     

Double bypass for inoperable pancreatic malignancy at laparotomy: postoperative complications and long-term outcome

INTRODUCTION

Between 4% and 13% of patients with operable pancreatic malignancy are found unresectable at the time of surgery. Double bypass is a good option for fit patients but it is associated with high risk of postoperative complications. The aim of this study was to identify pre-operatively which patients undergoing double bypass are at high risk of complications and to assess their long-term outcome.

METHODS

Of the 576 patients undergoing pancreatic resections between 2006 and 2011, 50 patients who underwent a laparotomy for a planned pancreaticoduodenectomy had a double bypass procedure for inoperable disease. Demographic data, risk factors for postoperative complications and pre-operative anaesthetic assessment data including the Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) and cardiopulmonary exercise testing (CPET) were collected.

RESULTS

Fifty patients (33 men and 17 women) were included in the study. The median patient age was 64 years (range: 39–79 years). The complication rate was 50% and the in-hospital mortality rate was 4%. The P-POSSUM physiology subscore and low anaerobic threshold at CPET were significantly associated with postoperative complications (p=0.005 and p=0.016 respectively) but they were unable to predict them. Overall long-term survival was significantly shorter in patients with postoperative complications (9 vs 18 months). Postoperative complications were independently associated with poorer long-term survival (p=0.003, odds ratio: 3.261).

CONCLUSIONS

P-POSSUM and CPET are associated with postoperative complications but the possibility of using them for risk prediction requires further research. However, postoperative complications following double bypass have a significant impact on long-term survival and this type of surgery should therefore only be performed in specialised centres.     

6,7-亚甲二氧基-1(2H,4H)-吖啶酮衍生物的合成及镇痛作用

报道13个6,7-亚甲二氧基-1(2H,4H)-吖啶酮衍生物的合成。初步药理实验表明:合成的化合物均有不同程度的镇痛作用,其中化合物Ⅱe的镇痛效力最强。     

Impaired renal allograft,but not patient survival,in patients with antibodies to hepatitis C virus

Background The impact of hepatitis C virus (HCV) infection in renal transplant patients is controversial and there are no data on the outcome of renal transplantation in this sub-group of Irish patients. Aim To examine the outcome of renal transplantation in patients with hepatitis C. Methods We examined the outcome of first grafts from renal transplant patients with hepatitis C antibody positive and compared them to a control group. During this period, 24 HCV positive patients received 33 grafts. All were treated with standard immunosuppression. Results Graft survival rate was less in the HCV positive cases (p=0.0087). Graft survival at 1 year was 75% in the HCV positive group versus 85% in the HCV negative group, 40% versus 62% at 5 years and 14% compared with 40% at 10 years. Patient survival was similar in both groups (p=0.78). Patient survival at 1 year was 96% versus 94%, 87% versus 80% at 5 years and 70% in both groups at 10 years. Conclusion In the Irish renal transplant population, the presence of hepatitis C antibodies, before or after transplantation is associated with worse long-term graft, but not patient survival.